Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care
To assess the correlates of unmet need for medical care among migrant children. A cross-sectional household survey used multistage sampling to identify migrant families in eastern North Carolina. Three hundred adult caretakers of 1 (per household) randomly selected child
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| Veröffentlicht in: | Pediatrics (Evanston) 2004-04, Vol.113 (4), p.e276-e282 |
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| container_title | Pediatrics (Evanston) |
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| creator | Weathers, Andrea Minkovitz, Cynthia O'Campo, Patricia Diener-West, Marie |
| description | To assess the correlates of unmet need for medical care among migrant children.
A cross-sectional household survey used multistage sampling to identify migrant families in eastern North Carolina.
Three hundred adult caretakers of 1 (per household) randomly selected child |
| doi_str_mv | 10.1542/peds.113.4.e276 |
| format | Article |
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A cross-sectional household survey used multistage sampling to identify migrant families in eastern North Carolina.
Three hundred adult caretakers of 1 (per household) randomly selected child <13 years old.
Fifty-three percent of the children had an unmet medical need. The most common reasons for unmet medical need were lack of transportation (80%) and lack of knowledge of where to go for care (20%). Unmet medical need was associated inversely with less than very good health (odds ratio [OR]: 0.31; 95% confidence interval [CI]: 0.16-0.61) and less than high school caretaker education (OR: 0.62; 95% CI: 0.39-0.98) and was associated directly with 1) having bed-days due to illness (OR: 2.46; 95% CI: 1.42-4.26), 2) lacking an annual well examination (OR:1.89; 95% CI: 1.12-3.20), 3) transportation dependence (OR:1.97; 95% CI: 1.24-3.13), 4) female gender (OR: 1.69; 95% CI: 1.07-2.67), 5) preschool age (OR: 2.24; 95% CI: 1.28-3.92), and 6) very high caretaker work pressure (OR: 5.01; 95% CI: 2.98-8.42). Adjustment using multiple logistic regression reveals unmet medical need to be independently associated with preschool age (OR: 2.08; 95% CI: 1.05-4.13) and very high caretaker pressure to work (OR: 5.93; 95% CI: 3.24-10.85). Of sampled children, 27% were preschool aged, and 40% had caretakers categorized with high work pressure.
Medical-access barriers among migrant children are largely nonfinancial. Preschool-aged migrant children disproportionately experience unmet medical need. Decreasing forgone care among migrant children will likely require a combination of individual, health-system, and labor-policy modifications.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.113.4.e276</identifier><identifier>PMID: 15060253</identifier><language>eng</language><publisher>United States: Am Acad Pediatrics</publisher><subject><![CDATA[Adult ; Agriculture ; Caregivers ; Child ; Child Health Services - statistics & numerical data ; Child, Preschool ; Cross-Sectional Studies ; Educational Status ; Female ; Health Services Accessibility - statistics & numerical data ; Health Services Needs and Demand - statistics & numerical data ; Hispanic Americans - statistics & numerical data ; Humans ; Infant ; Logistic Models ; Male ; Medically Uninsured - ethnology ; Medically Uninsured - statistics & numerical data ; North Carolina ; Sampling Studies ; Surveys and Questionnaires ; Transients and Migrants - statistics & numerical data]]></subject><ispartof>Pediatrics (Evanston), 2004-04, Vol.113 (4), p.e276-e282</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c333t-b41886d97f71900f9056092926f291d9b91d5cb18bcd8fcaff1c73d467e1b2603</citedby><cites>FETCH-LOGICAL-c333t-b41886d97f71900f9056092926f291d9b91d5cb18bcd8fcaff1c73d467e1b2603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15060253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weathers, Andrea</creatorcontrib><creatorcontrib>Minkovitz, Cynthia</creatorcontrib><creatorcontrib>O'Campo, Patricia</creatorcontrib><creatorcontrib>Diener-West, Marie</creatorcontrib><title>Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>To assess the correlates of unmet need for medical care among migrant children.
A cross-sectional household survey used multistage sampling to identify migrant families in eastern North Carolina.
Three hundred adult caretakers of 1 (per household) randomly selected child <13 years old.
Fifty-three percent of the children had an unmet medical need. The most common reasons for unmet medical need were lack of transportation (80%) and lack of knowledge of where to go for care (20%). Unmet medical need was associated inversely with less than very good health (odds ratio [OR]: 0.31; 95% confidence interval [CI]: 0.16-0.61) and less than high school caretaker education (OR: 0.62; 95% CI: 0.39-0.98) and was associated directly with 1) having bed-days due to illness (OR: 2.46; 95% CI: 1.42-4.26), 2) lacking an annual well examination (OR:1.89; 95% CI: 1.12-3.20), 3) transportation dependence (OR:1.97; 95% CI: 1.24-3.13), 4) female gender (OR: 1.69; 95% CI: 1.07-2.67), 5) preschool age (OR: 2.24; 95% CI: 1.28-3.92), and 6) very high caretaker work pressure (OR: 5.01; 95% CI: 2.98-8.42). Adjustment using multiple logistic regression reveals unmet medical need to be independently associated with preschool age (OR: 2.08; 95% CI: 1.05-4.13) and very high caretaker pressure to work (OR: 5.93; 95% CI: 3.24-10.85). Of sampled children, 27% were preschool aged, and 40% had caretakers categorized with high work pressure.
Medical-access barriers among migrant children are largely nonfinancial. Preschool-aged migrant children disproportionately experience unmet medical need. Decreasing forgone care among migrant children will likely require a combination of individual, health-system, and labor-policy modifications.</description><subject>Adult</subject><subject>Agriculture</subject><subject>Caregivers</subject><subject>Child</subject><subject>Child Health Services - statistics & numerical data</subject><subject>Child, Preschool</subject><subject>Cross-Sectional Studies</subject><subject>Educational Status</subject><subject>Female</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Health Services Needs and Demand - statistics & numerical data</subject><subject>Hispanic Americans - statistics & numerical data</subject><subject>Humans</subject><subject>Infant</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medically Uninsured - ethnology</subject><subject>Medically Uninsured - statistics & numerical data</subject><subject>North Carolina</subject><subject>Sampling Studies</subject><subject>Surveys and Questionnaires</subject><subject>Transients and Migrants - statistics & numerical data</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkMFvFCEUh4nR2LV69mY4eZvtA4Zh8LbZtGrS6sWmR8LAYxedXVaYiel_L5Nu0l6Al_f7fSQfIR8ZrJls-dUJfVkzJtbtGrnqXpEVA903LVfyNVkBCNa0APKCvCvlNwC0UvG35IJJ6IBLsSJ54xyWQqdEtzYjDSnT7T6OPuORpkDv4i7bKeVHutnl6OZxmrMd6UPKfzCXL_TGurotdFNKctFO6OlDnPb0_njAif7AOi_IO_TR1d7yx3vyJtix4IfzfUnub65_bb81tz-_ft9ubhsnhJiaoWV933mtgmIaIGiQHWiueRe4Zl4P9ZBuYP3gfB-cDYE5JXzbKWQD70Bcks9P3FNOf2cskznE4nAc7RHTXIxiSgvJuhq8egq6nErJGMwpx4PNj4aBWTSbRbOpmk1rFs218emMnocD-uf82eszch93-38x44KoeqrC8uL5Avkf4XSKfA</recordid><startdate>20040401</startdate><enddate>20040401</enddate><creator>Weathers, Andrea</creator><creator>Minkovitz, Cynthia</creator><creator>O'Campo, Patricia</creator><creator>Diener-West, Marie</creator><general>Am Acad Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040401</creationdate><title>Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care</title><author>Weathers, Andrea ; Minkovitz, Cynthia ; O'Campo, Patricia ; Diener-West, Marie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c333t-b41886d97f71900f9056092926f291d9b91d5cb18bcd8fcaff1c73d467e1b2603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Agriculture</topic><topic>Caregivers</topic><topic>Child</topic><topic>Child Health Services - statistics & numerical data</topic><topic>Child, Preschool</topic><topic>Cross-Sectional Studies</topic><topic>Educational Status</topic><topic>Female</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Health Services Needs and Demand - statistics & numerical data</topic><topic>Hispanic Americans - statistics & numerical data</topic><topic>Humans</topic><topic>Infant</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medically Uninsured - ethnology</topic><topic>Medically Uninsured - statistics & numerical data</topic><topic>North Carolina</topic><topic>Sampling Studies</topic><topic>Surveys and Questionnaires</topic><topic>Transients and Migrants - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weathers, Andrea</creatorcontrib><creatorcontrib>Minkovitz, Cynthia</creatorcontrib><creatorcontrib>O'Campo, Patricia</creatorcontrib><creatorcontrib>Diener-West, Marie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weathers, Andrea</au><au>Minkovitz, Cynthia</au><au>O'Campo, Patricia</au><au>Diener-West, Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2004-04-01</date><risdate>2004</risdate><volume>113</volume><issue>4</issue><spage>e276</spage><epage>e282</epage><pages>e276-e282</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>To assess the correlates of unmet need for medical care among migrant children.
A cross-sectional household survey used multistage sampling to identify migrant families in eastern North Carolina.
Three hundred adult caretakers of 1 (per household) randomly selected child <13 years old.
Fifty-three percent of the children had an unmet medical need. The most common reasons for unmet medical need were lack of transportation (80%) and lack of knowledge of where to go for care (20%). Unmet medical need was associated inversely with less than very good health (odds ratio [OR]: 0.31; 95% confidence interval [CI]: 0.16-0.61) and less than high school caretaker education (OR: 0.62; 95% CI: 0.39-0.98) and was associated directly with 1) having bed-days due to illness (OR: 2.46; 95% CI: 1.42-4.26), 2) lacking an annual well examination (OR:1.89; 95% CI: 1.12-3.20), 3) transportation dependence (OR:1.97; 95% CI: 1.24-3.13), 4) female gender (OR: 1.69; 95% CI: 1.07-2.67), 5) preschool age (OR: 2.24; 95% CI: 1.28-3.92), and 6) very high caretaker work pressure (OR: 5.01; 95% CI: 2.98-8.42). Adjustment using multiple logistic regression reveals unmet medical need to be independently associated with preschool age (OR: 2.08; 95% CI: 1.05-4.13) and very high caretaker pressure to work (OR: 5.93; 95% CI: 3.24-10.85). Of sampled children, 27% were preschool aged, and 40% had caretakers categorized with high work pressure.
Medical-access barriers among migrant children are largely nonfinancial. Preschool-aged migrant children disproportionately experience unmet medical need. Decreasing forgone care among migrant children will likely require a combination of individual, health-system, and labor-policy modifications.</abstract><cop>United States</cop><pub>Am Acad Pediatrics</pub><pmid>15060253</pmid><doi>10.1542/peds.113.4.e276</doi></addata></record> |
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| subjects | Adult Agriculture Caregivers Child Child Health Services - statistics & numerical data Child, Preschool Cross-Sectional Studies Educational Status Female Health Services Accessibility - statistics & numerical data Health Services Needs and Demand - statistics & numerical data Hispanic Americans - statistics & numerical data Humans Infant Logistic Models Male Medically Uninsured - ethnology Medically Uninsured - statistics & numerical data North Carolina Sampling Studies Surveys and Questionnaires Transients and Migrants - statistics & numerical data |
| title | Access to Care for Children of Migratory Agricultural Workers: Factors Associated With Unmet Need for Medical Care |
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